Bipolar disorder (also known as manic depression) causes extreme shifts in mood, energy, thinking and behavior–from the highs of mania to the lows of depression.

Unlike ordinary mood swings, the cycles of bipolar disorder last for days, weeks or months and are so intense that they interfere with the ability to function and meet everyday responsibilities. Fortunately, bipolar disorder is treatable. Since bipolar disorder tends to worsen without treatment, it’s important to get help as early as possible.

Signs and Symptoms

The causes of bipolar disorder aren’t completely understood, but it often runs in families. The first manic or depressive episode of bipolar disorder usually occurs in the teenage years or early adulthood. Bipolar disorder also can look very different in different people and the symptoms can be subtle and confusing. There are four types of mood episodes in bipolar disorder: mania, hypomania, depression and mixed episodes. Each type of mood episode has a unique set of symptoms.

Manic Symptoms

In the manic phase, feelings of heightened energy, creativity, and euphoria are common at first, but the behaviors tend to spiral out of control. Reckless and foolish behaviors usually soon follow.

  • Feeling unusually “high” and optimistic OR extremely irritable
  • Unrealistic, grandiose beliefs about one’s abilities or powers
  • Sleeping very little, but feeling extremely energetic
  • Talking so rapidly that others can’t keep up
  • Racing thoughts; jumping quickly from one idea to the next
  • Highly distractible, unable to concentrate
  • Impaired judgment and impulsiveness
  • Acting recklessly without thinking about the consequences
  • Delusions and hallucinations (in severe cases)

Hypomania Symptoms

Hypomania is a less severe form of mania where people feel euphoric, energetic and productive, but are still able to carry on with their day-to-day lives and are in touch with reality. People with hypomania may just appear to be in an unusually good mood. However, hypomania can result in bad decisions that harm relationships, careers and reputations because this phase often escalates to full-blown mania or is followed by a major depressive episode.

Depression Symptoms

Unlike regular depression, bipolar depression is more likely to involve irritability, guilt, unpredictable mood swings and feelings of restlessness. People with bipolar depression also tend to move and speak slowly, sleep a lot and gain weight. Additionally, they are more likely to develop psychotic depression where they lose touch with reality and experience major disability in work and social functioning. Other symptoms include:

  • Feelings of hopelessness, sorrow, emptiness
  • Irritability
  • Inability to experience pleasure
  • Fatigue or loss of energy
  • Physical and mental sluggishness
  • Appetite or weight changes
  • Sleep problems
  • Concentration and memory problems
  • Feelings of worthlessness or guilt
  • Thoughts of death or suicide

Most people with bipolar depression are not helped by antidepressants. In fact, antidepressants may make bipolar disorder worse–triggering mania or hypomania, causing rapid cycling between mood states, or interfering with other mood stabilizing drugs.

Mixed Episode Symptoms

Mixed episodes of bipolar disorder features symptoms of both mania or hypomania and depression. This combination of high energy and low mood makes for a particularly high risk of suicide.

  • Depression combined with agitation
  • Irritability
  • Anxiety
  • Insomnia, distractibility and racing thoughts.

The different faces of bipolar disorder

  • Bipolar I Disorder (mania or a mixed episode) – The classic manic-depressive form of the illness, characterized by at least one manic episode or mixed episode. Bipolar I Disorder usually—but not always—also involves at least one episode of depression.
  • Bipolar II Disorder (hypomania and depression) – In Bipolar II disorder, the person doesn’t experience full-blown manic episodes. Instead, the illness involves episodes of hypomania and severe depression.
  • Cyclothymia (hypomania and mild depression) – Cyclothymia is a milder form of bipolar disorder. It consists of cyclical mood swings. However, the symptoms are less severe than full-blown mania or depression.

Myths and Truths about Bipolar Disorder

  • Myth 1: People with bipolar disorder can’t get better or lead a normal life. Many people with bipolar disorder have successful careers, happy family lives and satisfying relationships. Treatment, healthy coping skills and a solid support system can help you manage symptoms and live a balanced life.
  • Myth 2: People with bipolar disorder rotate between mania and depression. Some people alternate between mania and depression, but most experience depression more often than mania. Also, mania may be so mild that it goes unrecognized. Many even go for long periods without symptoms.
  • Myth 3: Bipolar disorder only affects mood. Bipolar disorder affects energy levels, judgment, memory, concentration, appetite, sleep patterns, sex drive and self-esteem. Additionally, bipolar disorder has been linked to anxiety, substance abuse and health problems such as diabetes, heart disease, migraines and high blood pressure.
  • Myth 4: Aside from taking medication, there is nothing you can do to control bipolar disorder. While medication is the foundation of bipolar disorder treatment, therapy and self-help strategies play important roles. Exercising regularly, getting enough sleep, eating right, monitoring your moods, keeping stress to a minimum, and surrounding yourself with supportive people also help manage symptoms.

If you feel that you or someone you care about is experiencing symptoms of bipolar disorder please request an appointment with an iTherapy counselor to discuss your concerns.

See Also

  • Self-Assessment

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